title: Portal/splenic vein thrombosis following splenectomy in gastric cancer surgery.
abstract: Although splenectomy is often performed along with en bloc node dissection in gastric cancer surgery, portal/splenic vein thrombosis (PSVT) has been rarely reported. We recently encountered a case of PSVT after a splenectomy was performed during gastric cancer surgery. A 53-year-old woman underwent total gastrectomy, splenectomy, and en bloc regional lymph node dissection for gastric cancer. An uneventful postoperative course ended with abrupt development of a fever and general fatigue. Laboratory tests showed elevated levels of liver transaminases and fibrinogen degenerative products. Contrast-enhanced computed tomography revealed splenic vein thrombosis and partial liver infarction. Immediate anticoagulant treatment resulted in clinical improvement and partial thrombolysis in 2 months. PSVT after splenectomy in haematological disorders has been recognized as a possibly lethal complication. However, it has been underappreciated in cases of splenectomy for gastric cancer. The present case demonstrates the importance of considering PSVT as a possible complication of splenectomy in gastric cancer surgery.
authors.affiliation: Department of Gastroenterological Surgery, Transplant and Surgical Oncology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan. skagawa@md.okayama-u.ac.jp
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Kagawa
authors.forename: Futoshi
authors.initials: F
authors.lastname: Uno
authors.forename: Akira
authors.initials: A
authors.lastname: Gochi
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Naomoto
authors.forename: Toshiyoshi
authors.initials: T
authors.lastname: Fujiwara
mesh_terms: D002277:Carcinoma / Q000601:surgery*; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008875:Middle Aged; D011169:Portal Vein; D011183:Postoperative Complications; D013156:Splenectomy; D013162:Splenic Vein; D013274:Stomach Neoplasms / Q000601:surgery*; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*